Malacañang widens PhilHealth probe, sets 'timetable' for DOH
Malacañang wants concrete resolution on the controversies hounding the Philippine Health Insurance Corporation (PHIC) as it sets a timetable for the Department of Health (DOH) to conclude its investigation.
This, as regular monitoring was also ordered from the Office of Health Secretary Francisco Duque if only to arrive at an acceptable decision that will curb questionable claims at the PHIC.
Dubbed as PhilHealth, an in-house probe has since begun to establish validity of thousands in PhilHealth cataract claims. It is feared that at least P400 million worth of cataract cases in previous years were generated from practices now considered as unethical thus violative of PhilHealth rules.
A source from PhilHealth Central Office told The News Today (TNT) that amendments were already drawn and firmed up on the PhilHealth law in order to give the DOH and PhilHealth execs "semi- police powers."
However said amendments will still be presented to Congress.
It is also eyed to involve the National Bureau of Investigation (NBI) in the ensuing investigation with at least claims of ten Ilonggo doctors and two private hospitals now initially validated.
Earlier, PhilHealth has ordered a stop to payment of claims for cataract surgery during medical missions and through recruitment schemes amid reports of irregularities in claims of hospitals and doctors involving hundreds of millions of pesos.
In Circular No. 17 series of 2007, PhilHealth Acting President and Chief Executive Officer Lorna Fajardo ordered the discontinuance of the payments covering all claims for cataract operations with admission dates starting Nov. 1.
The circular cited as basis the PhiHealth Board Resolution No. 1046 series 2007, which directed the office to employ necessary measures to limit the number of claims for the procedure which may be compensated.
The circular did not cite the specific reasons why the payments for the claims have been stopped but it was issued amid persistent reports of alleged padding of PhilHealth claims for cataract operations and irregularities in the recruitment of patients.
PhilHealth investigators are looking into complaints and reports of alleged irregularities in cataract operations charged to the government insurance system. The alleged irregularities involve hundreds of millions of pesos in claims paid to hospitals and ophthalmologists in Western Visayas related to cataract operations.
The PhilHealth is also investigating complaints that the hospitals and doctors padded their claims to maximize payments by including medicines and services that were not availed of by the cataract patients.
Meanwhile, a Resolution has been filed before the House of Representatives calling for a congressional inquiry on controversial claims and reimbursements from PhilHealth.
Introduced Wednesday last week, at least forty solons signed the Resolution entitled "Resolution directing the proper committee of the House of Representatives to conduct an inquiry in aid of Legislation, on the alleged fraudulent claims being made to the Philippine Health Insurance Corporation."
Among the solons confirmed by TNT to have affixed their signatures were Iloilo First District Representative Janette Garin and Pangasinan Third District Representative Rachel Arenas. Also in the House move were Northern Samar First District Representative Paul Daza and Parañaque Second District Representative Roilo Golez.